1
Being a Physician Leader in a Challenging
Environment
PE6, February 11, 2019
Bobbie Byrne MD, Chief Information Officer, Advocate Aurora Health
2
Bobbie Byrne, MD MBA FAAP
Has no real or apparent conflicts of interest to report.
Conflict of Interest
3
• Develop key strategies that will make an impact in a VUCA
environment and identify specifically what actions are best used
under what circumstances
• Identify the impact of culture and how that should modify your
approach or generate warning signs
• Demonstrate how to tackle the "single source of truth" data
question and how to create a path to this goal while still providing
the key information needed to continue to care for patients and
run the business
• Discuss compelling patient and physician stories to gain
consensus or cause disruption as needed
Learning Objectives
4
Agenda
• “Leading” and “Challenging”
• A VUCA world
• The role of Culture and Data
• Sell it with a Story
5
6
• Step #1: Identify your Vision
• Step #2: Figure out what needs to be done
• Step #3: Do it
What to do when you don’t know what to do…Finding the Strategy
What to do when you don’t know how to do it/sell it…VUCA analysis
Leadership
7
Start with your True North
“About one time a year, our organization loses a surgical specimen
that requires the patient to return to the Operating Room and be
placed under repeat anesthesia for a repeat biopsy.”
“And it already happened this year to a 28 year old with Lupus
Pleuritis”
Yield: Funding of $30M for an integrated bar coded lab system
True North: Safety and Health Outcomes
• When everything is changing, commitment to the vision and
communication of the vision must be solid
8
• Go to the scene of the crime
• Ask open-ended questions
• Dig into the details
• Scan for outliers or patterns
• Get context
• Know your own biases
What to do…Finding the Strategy
9
• Compare a vendor selection circa 2003 to a vendor selection
today
– Clear requirements, limited data set and agreed optimal
outcome
– Moving requirements, endless data set and difficulty in
gaining consensus on the question, much less the answer
• Pull out your Five-year Strategic Technology Plan?
• Need a new way to look at this Challenging Environment
How to do it….
10
• Advanced by US Army War College to explain a post Cold War
world
– Volatility
– Uncertainty
– Complexity
– Ambiguity
• Provide leadership guidance based on recognizing VUCA
situations
– Utility of obtaining additional data
– Ability of experts able to predict response
VUCA
11
Volatility
• Unpredictable swings or unstable situation
• Some data is available: Not difficult to understand but not always
of great value
• Additional Expertise is valuable
• HIT examples:
– Cybersecurity breech risk
– Internet Service in some geographies
• Recommend:
– Stockpile additional experts
– Build in redundancy
• Cultural preparation: Surprises
– “Not IF, but WHEN”
12
• Cause and Effect basically understood but unsure if change will
happen
• Data is available
• Additional Expertise has minimal value
• HIT example:
– Competitive organization has just signed with your core
vendor, concern on staff recruitment
• Recommend:
– Obtain data, create plan
– Reconnaissance on competitive salary & benefits
• Cultural preparation: Move Quickly
– Prepare to pull the trigger immediately if needed
Uncertainty
13
Complexity
• Many interconnected parts.
• One variable changes several others
• Data can be available but often overwhelming to evaluate
manually
• Additional Expertise is valuable
• HIT Example:
– Planning for future regulatory requirements
• Recommend: Obtain or grow expert opinion
• Cultural preparation: Longer explanations
– More extensive organization education needed
– Creation of talking points, stories, vignettes to illustrate the
inter-related points
14
Ambiguity
• Don’t know what we don’t know
• Cause & Effect unclear
• Drivers of success unknown
• Data is not really available
• Additional Expertise has minimal value
• HIT Example:
– Digital Patient Apps
• Recommend: Experiment, Rapid Iteration
• Cultural preparation: Move without perfect information
– Embrace the “Fail Fast”
15
• Review VUCA Cultural impacts
– Surprises-Volatility
– Move Fast-Uncertainty
– Longer Explanations-Complexity
– Decide without Information-Ambiguity
• Compare with your organization’s culture
• Determine the type of challenge that is most problematic to your
culture
• Double down on efforts in that area in creation of both stories and
data
• Example: Surprises in Data Conversion
Role of Culture
16
• In search of the Almighty Source of Truth
• One hundred percent is probably not reasonable
• Most organizations have political third rails
• Transparent process and source
• Start with report governance rather than data element governance
• Identify the areas where you will go to the wall
– Executive level visibility
• Most important to weave the data into the story
• In VUCA situations where data is not helpful in determining action,
it can still be very helpful in selling/telling the story
• Example: Ambulatory go-live complexity
Role of Data
17
Story tellers
• Physicians are often the most influential people in the room-any
room…exam room, operating room, board room.
– Intelligent
– Highly skilled, highly trained
– At the front lines
• Accustomed to refining their words for the audience
• Take out the medical lingo
• Approach from the patient side—even more than physician side
• Refine the story—wash--rinse--repeat
18
End With Your True North
• When everything is changing, commitment to the vision and
communication of the vision must be solid
